scholarly journals A Wearable Device for Breathing Frequency Monitoring: A Pilot Study on Patients with Muscular Dystrophy

Sensors ◽  
2020 ◽  
Vol 20 (18) ◽  
pp. 5346
Author(s):  
Ambra Cesareo ◽  
Santa Aurelia Nido ◽  
Emilia Biffi ◽  
Sandra Gandossini ◽  
Maria Grazia D’Angelo ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Activity Patterns ◽  
Clinical Intervention ◽  
Ease Of Use ◽  
Wearable Device ◽  
Frequency Variation ◽  
Breathing Frequency ◽  
Patients At Risk ◽  
Variation Assessment ◽  
At Home

Patients at risk of developing respiratory dysfunctions, such as patients with severe forms of muscular dystrophy, need a careful respiratory assessment, and periodic follow-up visits to monitor the progression of the disease. In these patients, at-home continuous monitoring of respiratory activity patterns could provide additional understanding about disease progression, allowing prompt clinical intervention. The core aim of the present study is thus to investigate the feasibility of using an innovative wearable device for respiratory monitoring, particularly breathing frequency variation assessment, in patients with muscular dystrophy. A comparison of measurements of breathing frequency with gold standard methods showed that the device based on the inertial measurement units (IMU-based device) provided optimal results in terms of accuracy errors, correlation, and agreement. Participants positively evaluated the device for ease of use, comfort, usability, and wearability. Moreover, preliminary results confirmed that breathing frequency is a valuable breathing parameter to monitor, at the clinic and at home, because it strongly correlates with the main indexes of respiratory function.

Design and Usability of a Home Telerehabilitation System to Train Hand Recovery Following Stroke

2009 ◽  
Vol 3 (4) ◽  
Author(s):  
William K. Durfee ◽  
Samantha A. Weinstein ◽  
Ela Bhatt ◽  
Ashima Nagpal ◽  
James R. Carey
Keyword(s):  
Stroke Rehabilitation ◽  
Hand Function ◽  
Motor Program ◽  
Ease Of Use ◽  
Cortical Reorganization ◽  
Laptop Computer ◽  
File Server ◽  
Home Based ◽  
Treatment Paradigm ◽  
At Home

Current theories of stroke rehabilitation point toward paradigms of intense concentrated use of the afflicted limb as a means for motor program reorganization and partial function restoration. A home-based system for stroke rehabilitation that trains recovery of hand function by a treatment of concentrated movement was developed and tested. A wearable goniometer measured finger and wrist motions in both hands. An interface box transmitted sensor measurements in real-time to a laptop computer. Stroke patients used joint motion to control the screen cursor in a one-dimensional tracking task for several hours a day over the course of 10–14 days to complete a treatment of 1800 tracking trials. A telemonitoring component enabled a therapist to check in with the patient by video phone to monitor progress, to motivate the patient, and to upload tracking data to a central file server. The system was designed for use at home by patients with no computer skills. The system was placed in the homes of 20 subjects with chronic stroke and impaired finger motion, ranging from 2–305 mi away from the clinic, plus one that was a distance of 1057 miles. Fifteen subjects installed the system at home themselves after instruction in the clinic, while nine required a home visit to install. Three required follow-up visits to fix equipment. A post-treatment telephone survey was conducted to assess ease of use and most responded that the system was easy to use. Functional improvements were seen in the subjects enrolled in the formal treatment study, although the treatment period was too short to trigger cortical reorganization. We conclude that the system is feasible for home use and that tracking training has promise as a treatment paradigm.

scholarly journals Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice

2018 ◽  
Vol 68 (669) ◽  
pp. e279-e285 ◽  
Author(s):  
Tom Margham ◽  
Natalie Symes ◽  
Sally A Hull
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Patient Safety ◽  
Ease Of Use ◽  
High Yield ◽  
Case Review ◽  
Patients At Risk ◽  
Barriers To Implementation ◽  
Narrative Evaluation

BackgroundIdentifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations.AimThis study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety.Design and settingMixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice.MethodThe project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians.ResultsTrigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs’ work is generally reactive and GPs welcomed an approach that identified patients who were ‘under the radar’ of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time.ConclusionElectronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks.

Towards a Broad Use of Gamification Based on Hand Tracking in Post Stroke Patients

2019 ◽  
Author(s):  
Daniele Regazzoni ◽  
Andrea Vitali ◽  
Caterina Rizzi
Keyword(s):  
Motion Tracking ◽  
Daily Life ◽  
Low Cost ◽  
Research Work ◽  
Medical Personnel ◽  
Ease Of Use ◽  
Hand Tracking ◽  
Rehabilitation Programs ◽  
Patient Side ◽  
At Home

Abstract In the last years, the advent of innovative technologies for tracking human motions is increasing the interest of physicians and physiotherapist, who would like to introduce new instruments for a more objective assessment of the rehabilitation processes. At present, many motion tracking systems have been developed and their ease of use and low-cost may represent the key aspects for which these systems could be really adopted both in rehabilitation centers and in rehabilitation programs at home. Several research studies confirmed the importance of continuing rehabilitation programs at home with the aim to maintain patients’ health condition at a suitable level for daily life activities. Physicians and physiotherapists need methods and tools, which can be simply adaptable for each type of patients’ category and type of rehabilitation according to the assessed pathology. For achieving this need, the technology has to be suitable for both the patient side and medical personnel side. The most suitable technology for the patients are motion tracking devices which can be used through traditional IT, such as laptops, smartphones and tablets. Also for medical personnel the ease of use is very important, physicians would like to check the patient’s rehab exercises according to their medical knowledge by exploiting daily life technology. This research work investigates on which are the best user-friendly programming tools and low-cost technology for 3D hand and finger tracking for the development of a serious game for rehabilitation exercises. The tasks are designed according to physiotherapists’ recommendations, in order to be customizable for any single user. The following sections will describe the method, the tools adopted, and the application developed.

Validation of the Vertical Facial Growth Screening Test

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1187-1193
Author(s):  
Christian Calvo-Henriquez ◽  
Silvia Martins-Neves ◽  
Gabriel Martinez-Capoccioni ◽  
Daniela Neves-Leal ◽  
Alberto Ruano-Ravina ◽  
...  
Keyword(s):  
Screening Test ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Ease Of Use ◽  
Facial Growth ◽  
The Face ◽  
Patients At Risk ◽  
Low Sensitivity ◽  
Dentofacial Orthopedics ◽  
Test Retest Reliability

Background. Vertical facial growth has a high prevalence. Nonspecialized professionals have shown low sensitivity to identify patients at risk. In the face of this difficulty, we designed and validated a screening checklist for vertical facial growth. Methods. A multidisciplinary team of 5 members developed the Vertical Facial Growth Screening Test. A sample of 160 evaluations was obtained. We consider as the gold standard the evaluation of 2 specialists in dentofacial orthopedics. Results. Consistency measured with Cronbach α was .675 for 10 items. Test-retest reliability was .956. The interobserver concordance was .886. The receiver operating characteristic curve has .987 area under the curve. Conclusion. This is the first study to design and validate a screening checklist for vertical facial growth for nonexpert evaluators. We think that given its good performance, ease of use, inexpensiveness, and availability, the test could be useful for nontrained professionals dealing with children.

Use of a wearable device to assess sleep and motor function in Duchenne muscular dystrophy

2019 ◽  
Vol 61 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Benjamin I. Siegel ◽  
Ayse Cakmak ◽  
Erik Reinertsen ◽  
Macarthur Benoit ◽  
Janet Figueroa ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Motor Function ◽  
Wearable Device

scholarly journals Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients

2016 ◽  
Vol 42 (6) ◽  
pp. 453-456 ◽  
Author(s):  
Giuseppe Fiorentino ◽  
◽  
Anna Annunziata ◽  
Rosa Cauteruccio ◽  
Gianfranco Scotto di Frega ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Noninvasive Ventilation ◽  
Young Patients ◽  
Treatment Compliance ◽  
Gastric Distension ◽  
Nasal Mask ◽  
Positive Approach ◽  
Skin Breakdown ◽  
At Home

ABSTRACT Objective: To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV). Methods: We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. Results: The four patients tolerated MPV well and were compliant with NIV at home. MPV proved to be preferable and more comfortable than NIV with any other type of interface. Two of the patients required overnight NIV and eventually agreed to use a nasal mask during the night. Conclusions: The advantages of MPV over other types of NIV include fewer speech problems, better appearance, and less impact on the patient, eliminating the risk of skin breakdown, gastric distension, conjunctivitis, and claustrophobia. The use of a mouthpiece interface should be always considered in patients with DMD who need to start NIV, in order to promote a positive approach and a rapid acceptance of NIV. Using MPV during the daytime makes patients feel safe and more likely to use NIV at night. In addition, MPV increases treatment compliance for those who refuse to use other types of interfaces.

scholarly journals Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK

2017 ◽  
Vol 67 (660) ◽  
pp. e467-e473 ◽  
Author(s):  
Alice C Tompson ◽  
Sabrina Grant ◽  
Sheila M Greenfield ◽  
Richard J McManus ◽  
Susannah Fleming ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Waiting Room ◽  
Cross Sectional ◽  
History Of ◽  
The Uk ◽  
Patient Use ◽  
At Home

BackgroundBlood pressure (BP) self-screening, whereby members of the public have access to BP monitoring equipment outside of healthcare consultations, may increase the detection and treatment of hypertension. Currently in the UK such opportunities are largely confined to GP waiting rooms.AimTo investigate the reasons why people do or do not use BP self-screening facilities.Design and settingA cross-sectional, qualitative study in Oxfordshire, UK.MethodSemi-structured interviews with members of the general public recruited using posters in GP surgeries and community locations were recorded, transcribed, and coded thematically.ResultsOf the 30 interviewees, 20% were hypertensive and almost half had self-screened. Those with no history of elevated readings had limited concern over their BP: self-screening filled the time waiting for their appointment or was done to help their doctor. Patients with hypertension self-screened to avoid the feelings they associated with ‘white coat syndrome’ and to introduce more control into the measurement process. Barriers to self-screening included a lack of awareness, uncertainty about technique, and worries over measuring BP in a public place. An unanticipated finding was that several interviewees preferred monitoring their BP in the waiting room than at home.ConclusionBP self-screening appeared acceptable to service users. Further promotion and education could increase awareness among non-users of the need for BP screening, the existence of self-screening facilities, and its ease of use. Waiting room monitors could provide an alternative for patients with hypertension who are unwilling or unable to monitor at home.

Quantal breathing frequency variation in halothane anaesthetised neonatal rats

2005 ◽  
Vol 146 (2-3) ◽  
pp. 147-153 ◽  
Author(s):  
K.M. O’Keeffe ◽  
D.C. Galletly ◽  
J.H. Miller ◽  
P.D. Larsen
Keyword(s):  
Frequency Variation ◽  
Breathing Frequency ◽  
Neonatal Rats

scholarly journals Usability, usefulness, and acceptance of mRehab: A novel, portable rehabilitation system using smartphone and 3D print technology (Preprint)

2020 ◽  
Author(s):  
Sutanuka Bhattacharjya ◽  
Lora Anne Cavuoto ◽  
Brandon Reilly ◽  
Wenyao Xu ◽  
Heamchand Subryan ◽  
...  
Keyword(s):  
Technology Acceptance ◽  
Technology Use ◽  
Structured Interview ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Home Exercise ◽  
3D Print ◽  
System Usability Scale ◽  
Rehabilitation System ◽  
At Home

BACKGROUND Smart technology use in rehabilitation is growing and can be used remotely to assist clients in self-monitoring their performance. With written home exercise programs being the commonly prescribed form of rehabilitation after discharge, mHealth technology coupled with task-oriented programs can enhance self-management of upper extremity training. In the current study, a functional rehabilitation system, namely mRehab, was designed which included a smartphone app and 3D printed household items such as mug, bowl, key, and doorknob embedded with a smartphone The app's user interface allowed the participant to select rehabilitation activities and receive feedback on the number of activity repetitions completed, time to complete each activity and quality of movement. OBJECTIVE To assess the usability, perceived usefulness, and acceptance of the mRehab system by individuals with stroke and identify the challenges experienced by them when using the system remotely in a home-based setting. METHODS A mixed-methods approach was used with 11 individuals with chronic stroke. Following training, individuals with stroke used the mRehab system for six weeks at home. Each participant completed surveys and engaged in a semi-structured interview. Participants’ qualitative reports regarding the usability of mRehab were integrated with their survey reports and quantitative performance data. RESULTS Ten of the eleven participants rated the mRehab system between 67.5 to 97.5 percentile on the System Usability Scale, indicating their satisfaction with the usability of the system. Participants also provided high ratings of perceived usefulness (median=6), and perceived ease of use (median=5.75), on a 7-point scale based on the Technology Acceptance Model. Common themes reported by participants showed a positive response to mRehab with some suggestions for improvements. Participants reported an interest in activities they perceived to be of ‘just right challenge’. Some participants indicated a need for customizing the feedback to be more interpretable. Overall, most participants indicated that they would like to continue using the mRehab system at home. CONCLUSIONS Assessing usability in the lived environment over a prolonged duration of time is essential to identify match between the system and users’ needs and preferences. While mRehab was well accepted, further customization is desired for a better fit with the end users. CLINICALTRIAL NCT04363944

scholarly journals Measurement of salivary testosterone in adolescents and young men with Duchenne muscular dystrophy

2020 ◽  
Author(s):  
Yolanda Alins Sahun ◽  
Tim D Cheetham ◽  
Christopher Boot ◽  
Volker Straub ◽  
Claire L Wood
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Psychological Health ◽  
Healthy Population ◽  
Improvement Project ◽  
Salivary Testosterone ◽  
Age Appropriate ◽  
Physical And Psychological Health ◽  
Age Range ◽  
At Home

Abstract BackgroundMany young adults with Duchenne Muscular Dystrophy (DMD) receive long-term glucocorticoids (GC). GC can cause hypogonadotrophic hypogonadism and adolescents may therefore be candidates for pubertal induction. It is unclear whether men with DMD on or off GC have age-appropriate endogenous testosterone production. MethodsWe undertook a quality improvement project to assess the feasibility of measuring salivary testosterone (SalT) levels in men with DMD at home. A Sal-T sampling kit was sent by post to all patients with DMD, aged 17 and older, registered at the John Walton Muscular Centre in Newcastle (n=75). Submitted Sal-T samples were collected and submitted for analysis. Results28 out of 75 patients returned samples (age range: 17-34 years). 6/28 samples were unsuitable for analysis. Overall Sal-T levels (n=22) were significantly lower than in the healthy population (178 ±107 v 287 ±109 pmol/l, p=0.0001). Sal-T was lower in those on GC compared to those off GC (144± 81 versus 218 ±125 pmol/l, p=0.05). 3 patients were unable to collect a sample due to ventilator dependence.ConclusionSal T can provide a useful method of assessing androgen status in DMD patients at home, overcoming barriers such as mobility difficulties or venepuncture. However we only obtained samples in a minority of patients suggesting that Sal-T measurement may not be appropriate or acceptable to everyone. There needs to be a more detailed exploration of the barriers to sample submission and a greater understanding of the implications of testosterone status on physical and psychological health in DMD patients.

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